Intshayelelo
I-Achalasia yeCadia (AC) yiIsiphazamiso se-esophagelity scurity.Ngenxa yokuphumla okuhlwempuzekileyo kwe-schegegeal ye-schegegeal esezantsi (i-les) kunye nokusilela kwe-esophagegel peristals, ukugcinwa kokutya kubanzii-dysphagia kunye nokuphendula. Iimpawu zeklinikhi ezinje ngentlungu, intlungu yesifuba kunye nokuphulukana nobunzima.Ukuxhaphaka kum malunga ne-32.58 / 100,000.
IunyangoI-Achalasia ikakhulu ibandakanya unyango olungahlikiyo, unyango lokunyanga kunye nonyango.
I-01emed
Indlela yokunyanga yeziyobisi kukunciphisa uxinzelelo lwe-les kwixesha elifutshane.Akukho bungqina bubonakalayo ukuba iziyobisi zinokuqhubeka nokuphucula iimpawu ze-AC.Okwangoku amachiza asetyenziswayo asetyenziswayo aquka i-niite, i-calcium Channers, kunye ne-agonists.
(1)I-nitra, ezinje ngeNitroglycerin, i-Amyl Nitrate, kunye ne-i-i-i-i-i-i-Idasibrate
(2)I-calcium Channel blockers, njenge-nifdipine, verapamil, kunye ne-williazem
(3)I-β-iarptor agodons, njengeCabuterol
I-02endoscopic Botulinum ye-Toxin inaliti (BTI)
I-Endoscopic Botulinum Inaliti ye-Toxin inaliti (BTL) inokusetyenziselwa ukunyanga i-AC,Kodwa inokubonelela kuphela ngeziphumo zexeshana zethutyana kwaye zinokusetyenziswa kwizigulana ezikhulileyo ezinemingcipheko ephezulu yotyando nakwi-anesthesia.
1) Iimpawu:abaguli abakwiminyaka eli-ADAD nabadala (> iminyaka engama-40); Abo bangakwaziyo ukunyamezela i-Tooscopic balloon Delation (PD) okanye unyango lonyango; abo banonyango lwe-PD okanye iziphumo ezingalunganga zonyango; Abo banee-Esophagegeal Ngexesha lonyango lwePD kwabo banobungozi obuphezulu, inokusetyenziswa ngokudibeneyo ne-PD; Ingasetyenziselwa njengenguqu yokutya okanye unyango lwe-PD.
(2) Ukuphikisana:Akucetyiswa ukuba kunyango lodidi lokuqala lwe-AC kwizigulana ezincinci (≤40).
I-03endoscopic balloon dilation (PD)
Ukuchithwa kweBalloon kuneziphumo ezithile kwi-AC, kodwa kufuna unyango oluninzi kwaye kuthwala umngcipheko wengxaki enkulu.
(1) Iimpawu:Izigulana ze-AC ngaphandle kwentliziyo yentliziyo, ukungasebenzi kakuhle kwe-caagsfunction, njl.; abantu abangaphezulu kweminyaka engama-50 nabafazi abangaphezu kweminyaka engama-35; Izigulana eziphelelwe utyando. Ingasetyenziswa njengendlela yokuqala yonyango.
(2) Ukuphikisana:I-Cardiopulmonary enzima, ukungasebenzi kakuhle kunye nokungasebenzi kakuhle kunye nomngcipheko omkhulu wokungasebenzi kakuhle kwe-esophageli.
I-04peral tooscopic mytomy (umbongo)
Kwiminyaka yakutshanje, ngokuphunyezwa okukhulu kwe-Peroral Endotopic MyOtomy (umbongo), izinga lempumelelo lonyango lweklinikhi lwe-AC inda kakhulu.Unyango lombongo lwe-AC luhambelana kakhulu nomqondo "ophambeneyo, oko kukuthi, izilonda zisuswe / zisuswe ngexesha lenkqubo yonyango, kunye namalungu asuswayo.Ukunyaniseka kunye nokusebenza kwesakhiwo se-Aatomive kugcinwa, kwaye umgangatho wobomi obungenasigulana ungachaphazelekanga. Ukuvela kombongo wenze unyango lwe-AC i-AC PREALD.
Umzobo: Amanyathelo otyando
Ukusebenza kwegama eliphakathi kunye nexesha elide kunye nonyango lonyango lwe-AC kuyahambelana ne-Laparoscopic Heller Mylermy (LHM)inokusetyenziswa njengenketho yonyango lokuqala.Abanye abaguli banokuhlakulela iimpawu ze-Gerroesegeal Reallux emva kotyando
(1) Iimpawu ezibalaseleyo:I-AC ngaphandle kokunamathezeka okukhulu, ukusebenza kwe-guricric proptives
(2) Izalathiso eziDibeneyo:I-Spasm ye-Esophageal Spasm, iSutcracker Esophagus kunye nezinye izifo ze-Esophageli, izigulana ezingekho mbongo osilelayo okanye utyando lomlondolozi, kunye ne-AC nge-esophagegeal suheshegeal suheshegeal suheshegeal suheshegeal.
(3) Ukuphikisana:Izigulana ezine-AYSFRURY DYSFTUST, isifo samaqadi esiqatha, imeko ngokubanzi, njl njl.
I-05laparoscopic Heller Myletomy (LHM)
I-LHM inomsebenzi wokusebenza wexesha elide kwinkonzo yexesha elide ekunyangeni i-AC, kwaye ithathiwe ngumbongo kwiindawo apho imvume yemvume.
I-06surrual esophagectomy
Ukuba i-AC idityaniswe ne-stenosis esezantsi, i-tururs, njl., Njl.
Thina, iJiangxi Zhuoruhiuuuuuuuhui-biopsy godps, i-hemoclip, I-Polyp gorare, Inaliti ye-sclerotherapy, ukutshiza i-catheter, Ibrashi ye-cytology, isikhokelo, Ibhasikithi yokubuyisa ilitye, I-Nasal Biling Drasheter Casheter catheternjl.Ems, Esd,I-ERCP. Iimveliso zethu kufuneka ziqinisekiswe, kwaye izityalo zethu ziqinisekisiwe. Impahla yethu ithunyelwe eYurophu, iMntla Melika, eMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana umthengi wokuqonda kunye nokudumisa!
IXESHA LOKUQALA: UJUL-09-2024